Feb 19 Thyroid Disease: A Silent Affliction

Cancer. Diabetes. HIV. Alzheimer’s. The mere mention of diseases like these, recognized for their profound effects and widespread occurrences across the globe, likely conjures up images of suffering, hardship, and a desire to find a cure. Researchers and activists have dedicated their careers to ending diseases such as cancer, and organizations continue to funnel millions upon millions of dollars a year to bring an end to these harmful ailments. However, the captivation of the American public with just a select few diseases comes with a major downside: many other deleterious conditions continue to be misunderstood, under diagnosed, and largely ignored. As such, these diseases remain silent- unnoticed by the public eye and untouched by researchers. Even worse, sufferers may not even know they are afflicted, or, even if they have been diagnosed, their disease may have no current cure, as a cure is dependent upon funding for research. This issue of inattention manifests particularly strongly in thyroid diseases, which demonstrate the unfortunate hierarchy of disease research and the perceived importance of discovering a cure.

Thyroid diseases affect roughly 5 to 10 percent of the population and include a variety of conditions that impact hormone production. [1,2] Such diseases include Grave’s disease, which results in an overactive thyroid (hyperthyroidism), and Hashimoto’s thyroiditis, which is associated with both hyper- and hypothyroidism. [3] The thyroid, a small, butterfly-shaped endocrine gland in the lower neck, secretes vital hormones into the blood. [3,4] These hormones help regulate body functioning, contribute greatly to metabolic rate and related operations, and assist in growth and maturation. [3] While a healthy thyroid is essential to many bodily processes, it is estimated that in the US alone, there are approximately 20 million individuals who have some sort of thyroid disease. [5] Yet, despite the importance of a properly-functioning thyroid, as many as 60 percent of cases go undiagnosed, meaning people do not get medical attention that could drastically improve their lives. [5] To make matters worse, undiagnosed thyroid disorders can lead to many other serious conditions including cardiovascular disease and osteoporosis. [5]

Despite the lack of attention given to thyroid disorders in the past, recent efforts have been made to answer fundamental questions about the thyroid and its associated diseases. Specifically, new scientific breakthroughs show substantial promise for finding a cure to these all-too-common diseases. Earlier this month, researchers at the Boston University School of Medicine (BUSM) discovered a way to produce thyroid cells from mouse stem cells, which is considered by many to be the first key step in engineering human thyroid cells to treat and study thyroid diseases.2,5

In the study, published in Stem Cells Reports, researchers were able to utilize genetically modified embryonic stem cells from mice to produce functioning thyroid cells called thyrocytes. [2,6] The stem cells were engineered to express a genetic switch for the gene Nkx2-1, which is critical for thyroid development. [2,6] The Nkx2-1 was switched on and off at various points of embryonic development, and the resulting data lead to the discovery of a narrow window where turning on the gene resulted in most of the embryonic cells converting to thyroid cells. [2,5,6] With time, researchers believe they may be able to use similar processes to produce other specialized cells such as lung cells, liver cells, and insulin-producing cells. [2] Furthermore, while the study used only mouse embryonic cells, scientists hope that they will be able to apply similar techniques to human embryonic cells as well, which would provide greater understanding about the nature of thyroid diseases and the most effective methods of treatment.

While stem cell use in research remains controversial, whether it is animal embryos or human embryos in question, developments like BUSM’s display the critical importance that embryos play in the understanding and treatment of diseases. To sacrifice their use in research would mean sacrificing the chance at a high quality life for those who are currently suffering due to a lack of effective treatments available. While the embryos themselves will not grow to maturation, their purpose within the scientific community is unequivocal. Currently, the causes of thyroid diseases are largely unknown, and there is no cure for these diseases; a diagnosed individual must have lifelong medical treatment via medications in order to maintain hormone levels within the optimal range. [5,7] As thyroid diseases affect a significant portion of the population, developments in understanding and treatment would have an extremely positive effect on the lives of millions of sufferers, making it easier for them to manage their conditions.

Despite the prominence of thyroid diseases within our society and the lack of answers about them, funding for thyroid research has not increased in the past 20 years. [1] This lack of financial support places a severe handicap on the ability of research teams like BUSM to conduct substantial and impactful research due to a lack of funds. While diseases like cancer, known for its detrimental effects, have gained notorious funding and support, ailments like Grave’s disease, Hashimoto’s thyroiditis, thyroid nodules, and goiters have been pushed aside, despite the ongoing problems those who are diagnosed face due to a lack of significant research regarding thyroid disorders. Due to this limited funding, many continue to suffer, despite the opportunity for advancement and treatment if more research was conducted. Consequently, perhaps it is best to ask ourselves: How do we decide which diseases to spend money fighting and which ones to neglect, and how can we ethically justify funding some diseases over others? Thyroid disorders, which have long gone under-noticed despite their significant occurrence, deserve more attention from the public, from researchers, and from funders alike if we ever want to make an advancement for the millions afflicted with these diseases.

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